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Richmond Remembers Pregnancy and Infant Loss with CHoR at VCU

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October is National Pregnancy and Infant Loss Awareness Month

It's a grief few know how to talk about, but miscarriage and infant death are heartbreakingly common. In the U.S., one out of every five or six confirmed pregnancies ends in miscarriage. One in about 200 pregnancies ends in stillbirth. More infants die within their first 24 hours of life: about 11,300 every year. In honor of National Pregnancy and Infant Loss Remembrance Month, we're speaking this week and next with Richmond medical and grief experts, starting with Dr. Tiffany Kimbrough, medical director of the newborn nursery at the Children's Hospital of Richmond at VCU.

What’s the one piece of advice you give the most often?
As a pediatrician, the best piece of advice I can give to expectant moms is to attend early and regular prenatal care visits. We know that by visiting your OBGYN on a consistent basis, prenatal conditions that could potentially harm you or your baby, like high blood pressure and diabetes, can be detected and treated.  Babies are also monitored for proper growth and development through these visits. There are situations where infants need to be delivered early for best outcomes, and your OBGYN can plan the best course of action with you in these instances.

What are some of the universal experiences you’ve seen in your work?
Each stillbirth or infant death carries with it a tremendous weight that cannot be known by anyone who has not experienced it. I have had the unfortunate experience to sit with a parent as their child has taken his or her last breath, to attend funerals with impossibly small caskets, and cry my share of tears with parents who feel that gaping hole in their hearts created by the void of what once was. There is no magical gestational age or infant age that lessens the pain. It is a life lost, a hope that has been prematurely interrupted. Every parent grieves this loss in a different way; there is no right or wrong way to process it. 

What’s one thing you’d like to share with an expectant family?
Once your child is born, there is a multitude of information that exists on the “best way” to raise your baby. It can be overwhelming to try to process it all, and not all advice or information available is created equal. Finding a pediatrician that you trust, who practices evidenced-based medicine, to help sift through all of the noise and make a parenting plan is of utmost importance. From infant safe sleep, regular vaccination, and breastfeeding – there are many choices you can make after birth to help minimize the risk of infant death. 

What are some ways others can help support an expectant family?
I encourage grandparents and extended family members to inform themselves on recommendations for infant care. There are many constants to helping a baby thrive – like feeding, love, and nurturing, but there are often areas that have changed from generation to generation as our medical knowledge has grown. It is important to support expectant families with the wisdom of experience, while also recognizing when there may be updated guidance that is offered.

Are there any aspects of healthy pregnancy and infant-loss prevention others may find surprising?
You can already start protecting your baby before ever getting pregnant! Having a normal body mass index (BMI, aka weight for your particular height), can help protect against the risk of stillbirth. In addition, quitting smoking prior to pregnancy is another way you can help keep your future baby healthy. Women should abstain from using drugs and alcohol while pregnant to promote overall fetal growth and development. If you have a condition like diabetes or high blood pressure, it is important that these conditions are well-controlled before becoming pregnant in order to protect your baby. Lastly, it is recommended that women begin taking prenatal vitamins at least three months before trying to conceive in order to build up enough folate for healthy brain and nerve development.

Is there anything else you’d like to share that you think can help others?
I also like to encourage parents and close caregivers to attend an infant CPR course and to stay informed on hazards that may impact their baby at various developmental time points. Ensuring proper car seat fit and installation is tremendously important throughout infancy into childhood. Once solids are introduced, parents must also become weary of choking hazards.  With the mobility of late-infancy, baby-proofing is a new area of focus. From safe storage of medicines and chemicals, to mounting furniture and securing stairways, there is a lot for new families to consider that they likely didn’t have to before. I encourage parents to bring their questions about making their home safe to appointments and review these areas at each well child visit.

Despite our best efforts, there are times when tragedy strikes.  These losses grip families and their surrounding communities. We are all left asking, “What could have been done differently?”  This may represent a way of coping with loss for some. While it is important to try to prevent every death, and to give our best efforts to arm families with knowledge to protect their babies, it is also critical to recognize the impact of losing a child on their family and on us as providers. I encourage family members to attend perinatal loss support groups or grief counseling to process what no one could ever plan for. It is also essential for the healthcare team to practice self-care in the wake of tragedy, in order to remain resilient in our line of work and continue providing humanistic, quality care for families and their children.

Richmond MISS Foundation: Karla Helbert spoke with us about the grief of pregnancy and newborn loss.
Good Mourning Counseling: Anisa Glowczak shares more about the intimate aspects of this kind of grief.

The MISS Foundation:
 This international nonprofit provides counseling, advocacy, research, and education to families experiencing the death of a child
Kennedy's Angel Gowns: This local nonprofit provides free hand-crafted final-rest garments to bereaved families who have suffered the loss of a child before, during, or shortly after birth.
Mourning Miscarriage: learn how an often silent-grief is growing a voice. Grief Groups - Loss of a Child: Connect with other families who can understand and share your journey on Facebook.